FORM 1023-EZ for MITBU PROGRAM INC

Field Data
EIN 27-0913778
Case Number EO-2018249-000138
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MITBU PROGRAM INC
Organization’s Mailing Address 172 W WARREN AVE
City LONGWOOD
State FL
ZIP 32750
Accounting period End 12
Primary contact name SHEILA DIXON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHEILA DIXON
EXECUTIVE DIRECTOR
1105 FOLKSTONE DRIVE
MCDONOUGH GA 30253

Officer/Director/Trustee Two

SHATAKIA NILES
CO CHAIRPERSON
118 BARRY STREET
DECATUR GA 30030

Officer/Director/Trustee Three

TARA WALLACE
DIRECTOR
125 LAWN MARKET
SHARPSBURG, GA 30277

Officer/Director/Trustee Four

SHEROD MITCHELLL
DIRECTOR
920 W 11 STREET
SANDFORD FL 32771

Officer/Director/Trustee Five

JOHN JOHNSON
DIRECTOR
5445 ANLANTIS PLACE
MABLETON GA 30126

Organization’s website NSWEAVERRESTORATION
Organization’s email SDIXON@NSWEAVERRESTORATION.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/29/09
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SHEILA DIXON
Signature Title EXECUTIVE DIRECTOR
Signature Date 9/4/18

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